LDL reduction: how low should we go and is it safe?
High-dose statin therapy or combination statin treatment is necessary for most patients to achieve aggressive low-density lipoprotein cholesterol goals. Adding ezetimibe or bile acid sequestrants appears unlikely to increase the risk of myopathy. Although the combination of niacin or fenofibrate with moderate-dose statins appears to be reasonably safe, the safety of combination with high-dose statins has yet to be determined. To enhance patient outcomes, attention must be paid to characteristics that predict muscle and hepatic statin toxicity when considering using high-dose statin or combination statin therapy.
Robinson
Jennifer G
JG
Lipid Research Clinic, 200 Hawkins Drive SE 226 GH, Iowa City, IA 52242, USA. jennifer-g-robinson@uiowa.edu
D000499:Allylamine / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use; D000924:Anticholesteremic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001384:Azetidines / Q000009:adverse effects / Q000627:therapeutic use*; D008078:Cholesterol, LDL / Q000097:blood* / Q000187:drug effects*; D000069472:Colesevelam Hydrochloride; D003324:Coronary Artery Disease / Q000188:drug therapy* / Q000517:prevention & control; D018450:Disease Progression; D004359:Drug Therapy, Combination; D000069438:Ezetimibe; D011345:Fenofibrate / Q000627:therapeutic use; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D006949:Hyperlipidemias / Q000188:drug therapy* / Q000517:prevention & control; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D009135:Muscular Diseases / Q000139:chemically induced; D009525:Niacin / Q000627:therapeutic use; D012307:Risk Factors; D020521:Stroke / Q000517:prevention & control
D000924:Anticholesteremic Agents; D001384:Azetidines; D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000960:Hypolipidemic Agents; D009525:Niacin; D000499:Allylamine; D000069438:Ezetimibe; D000069472:Colesevelam Hydrochloride; D011345:Fenofibrate